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Liu Q, Tooki T, Di D, Zhou H, Cui Z, Zhang R, Zhang J, Yuan T, Zhou T, Luo X, Ling D, Wang Q. Role of lifestyle factors in mediating the effect of educational attainment on bone mineral density: a Mendelian randomization study. Arch Osteoporos 2023; 18:120. [PMID: 37723362 DOI: 10.1007/s11657-023-01329-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
We performed two-step multivariable Mendelian randomization analysis to explore the mediating role of lifestyle factors in educational attainment (EA) and bone mineral density (BMD). Summary statistics from genome-wide association studies of European lineages were used. Coffee intake and processed-meat intake mediated the association between EA and BMD. PURPOSE This study aimed to explore the causal relationship between educational attainment (EA) and bone mineral density (BMD), as well as the potential mediating roles of lifestyle factors in the expected EA-BMD relationship. By identifying modifiable lifestyle factors, we hope to provide relevant information to prevent osteoporosis or low BMD in the less educated population. METHODS Using summary statistics from genome-wide association studies (GWAS) of major European lineages, one- and two-sample Mendelian randomization (MR) analyses were performed to estimate the association between EA (in the social sciences genetic association consortium (SSGAC) involving 766,345 individuals and in the UK Biobank (UKB) involving 293,723 individuals) and BMD (in the Genetic Factors for Osteoporosis Consortium involving 426,824 individuals selected from the UKB). The EA variable in both consortia were expressed by years of schooling completed. Two-step multivariable MR was used to assess the mediating roles of eight lifestyle-related factors (moderate-to-vigorous physical activity, watching television, computer using, smoking initiation, coffee intake, alcohol intake frequency, tea intake, and processed-meat intake) in the EA and BMD association, and the corresponding mediating proportion was calculated. Meta-analysis was used to present a pooled estimate. RESULTS A total of 317 and 73 independent single-nucleotide polymorphisms (SNPs) of GWAS significance (P < 5.0 × 10-8) were selected as instrumental variables (IVs) for EA in the SSGAC and UKB, respectively. A total of 513 SNPs were selected as IVs for the BMD. The results of one- and two-sample MR revealed that the genetically predicted BMD increased by 0.094 and 0.047 g/cm2, respectively, in response to each SD increment of genetically predicted schooling years. Among the eight candidate mediators, coffee intake and processed-meat intake were potential mediators revealed by the two-step multivariable MR analysis, mediating 26.87% and 23.92% of EA's effect on BMD, respectively. Meta-analysis showed consistent findings. Results of sensitivity analysis indicated the robustness of our findings. CONCLUSION We elucidated the causal protective effect of EA on BMD and the mediating roles of coffee intake and processed-meat intake. Intervening with these factors can potentially reduce the burden of bone density loss or osteoporotic fractures among the less educated population.
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Affiliation(s)
- Qian Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tiaeki Tooki
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongsheng Di
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haolong Zhou
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhangbo Cui
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruyi Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianli Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Yuan
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Zhou
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao Luo
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Danyang Ling
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Wang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Asoudeh F, Bagheri A, Larijani B, Esmaillzadeh A. Coffee consumption and caffeine intake in relation to risk of fractures: a systematic review and dose-response meta-analysis of observational studies. Crit Rev Food Sci Nutr 2022; 63:9039-9051. [PMID: 35475944 DOI: 10.1080/10408398.2022.2067114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Conflicting reports are available about the association of coffee or caffeine intake and risk of fracture. We performed the current updated systematic review and dose-response meta-analysis of coffee consumption and caffeine intake and risk of fracture to quantify this association. MATERIALS AND METHODS PubMed/Medline, ISI Web of Science, and Scopus, Cochrane database were searched up to July 2021. Random-effects model or fixed-effects model was used to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs). Dose-response relationship was examined using linear and non-linear dose-response analyses. The certainty of evidence was assessed using NutriGrade tool. RESULTS Out of 22 eligible studies included in the meta-analysis, 15 had cohort and 7 had case-control design. We found no significant association between coffee consumption and risk of fracture, either based on pooling cohort (RR: 0.99; 95% CI: 0.88, 1.12; I2 = 71.4%, Pheterogeneity < 0.01) or case-control studies (OR: 1.13; 95% CI: 0.87, 1.46; I2 = 49.0%, Pheterogeneity=0.08). In the subgroup analysis of cohort studies, we observed that higher coffee intake was inversely associated with risk of fracture in men (RR: 0.85; 95% CI: 0.76 to 0.94). In addition, a positive association was seen between coffee consumption and risk of fracture in studies with less than 12 years of follow-up (RR: 1.14; 95% CI: 1.02 to 1.27). With regard to caffeine intake, a statistically significant positive association was seen with risk of fracture (RR: 1.15; 95% CI, 1.08 to 1.23; I2=26.6%, n = 8). In the dose-response analysis, we found that each additional 100 mg caffeine intake was marginally associated with 2% greater risk of fracture (RR: 1.02; 95% CI: 1 to 1.05; I2= 70.3%, n = 6). CONCLUSION High coffee consumption was protectively associated with risk of fracture in men, while caffeine intake was positive associated with risk.
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Affiliation(s)
- Farzaneh Asoudeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Bagheri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Is Impregnation of Xenograft with Caffeine Effective on Bone Healing Rate in Mandibular Defects? A Pilot Histological Animal Study. J Maxillofac Oral Surg 2019; 19:85-92. [PMID: 31988569 DOI: 10.1007/s12663-019-01221-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/23/2019] [Indexed: 10/27/2022] Open
Abstract
Introduction and Aim The aim of this study was to evaluate the effect of two concentrations of caffeine (1.5% and 3%) powder added to Bio-Oss xenograft on bone healing rate of iatrogenic mandibular defects in dogs. Materials and Method The researchers implemented a pilot study on ten male adult mongrel dogs. Two 4-mm circular critical-sized defects were trephined on each side of the mandibular body (a total of 4 defects for each dog). One of the defects remained empty as a control group. The other three defects in each case were randomly filled with 1.5% or 3% caffeinated Bio-Oss or pure Bio-Oss. The mandible specimens were sent for histological and histomorphometric assessments, 4 months postoperatively. Our predictor variable was the type of bone substitute. The study outcomes were new bone formation, angiogenesis, and fibrosis. The p value was set at 0.05 using SPSS 16. Results The histological assessment showed that the administration of 1.5% caffeinated Bio-Oss to mandibular defects caused more angiogenesis and more new bone formation as well as less fibrosis compared to the other groups (p < 0.05). Conclusion This study suggested that the application of 1.5% caffeinated Bio-Oss in bone defects of dogs resulted in the higher new bone formation. However, further clinical trials are needed to support its relevancy.
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Huan HC, Chang HJ, Lin KC, Chiu HY, Chung JH, Tsai HC. A closer examination of the interaction among risk factors for low back pain. Am J Health Promot 2013; 28:372-9. [PMID: 24200334 DOI: 10.4278/ajhp.120329-quan-171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the interactions of risk factors and identify their most powerful discrimination pathway for the occurrence of low back pain (LBP). DESIGN A cross-sectional study. SETTING Taiwan. SUBJECTS Taiwanese population of 30 to 64 years old. MEASURES A self-reported question, "Have you experienced LBP within the last 3 months?" was used to evaluate LBP. The study variables included demographics (age, gender, occupation, education level, marital status, and household income), biometric health measures (bone mineral density and body mass index), dietary habits (weekly milk, coffee, tea, and soybean consumption), and other lifestyle factors (smoking habits, alcohol consumption, betel nut chewing, body weight control, exercise regularity, and stress management). ANALYSIS Logistic regression and classification tree analyses. RESULTS A total of 969 Taiwanese participants were analyzed. Primary logistic regression analysis identified three critical risk factors (gender, bone mineral density, and exercise regularity) for the occurrence of LBP. By classification tree analysis, demographic factors, dietary habits, and lifestyle factors had modifying effects on LBP. CONCLUSIONS Various factors contribute to the risk of LBP. Interactions between risk factors should be considered when developing future strategies for the prevention and management of LBP.
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The impact of coffee on health. Maturitas 2013; 75:7-21. [DOI: 10.1016/j.maturitas.2013.02.002] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 02/04/2013] [Accepted: 02/07/2013] [Indexed: 01/27/2023]
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Abstract
INTRODUCTION Recent studies have indicated higher risk of fractures among coffee drinkers. To quantitatively assess the association between coffee consumption and the risk of fractures, we conducted this meta-analysis. MATERIAL AND METHODS We searched MEDLINE and EMBASE for prospective studies reporting the risk of fractures with coffee consumption. Quality of included studies was assessed with the Newcastle Ottawa scale. We conducted a meta-analysis and a cumulative meta-analysis of relative risk (RR) for an increment of one cup of coffee per day, and explored the potential dose-response relationship. Sensitivity analysis was performed where statistical heterogeneity existed. RESULTS We included 10 prospective studies covering 214,059 participants and 9,597 cases. There was overall 3.5% higher fracture risk for an increment of one cup of coffee per day (RR = 1.035, 95% CI: 1.019-1.052). Pooled RRs were 1.049 (95% CI: 1.022-1.077) for women and 0.910 (95% CI: 0.873-0.949) for men. Among women, RR was 1.055 (95% CI: 0.999-1.114) for younger participants, and 1.047 (95% CI: 1.016-1.080) for older ones. Cumulative meta-analysis indicated that risk estimates reached a stabilization level (RR = 1.035, 95% CI: 1.019-1.052), and it revealed a positive dose-response relationship between coffee consumption and risk of fractures either for men and women combined or women specifically. CONCLUSIONS This meta-analysis suggests an overall harm of coffee intake in increasing the risk of fractures, especially for women. But current data are insufficient to reach a convincing conclusion and further research needs to be conducted.
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Affiliation(s)
- Huifang Liu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Yao
- Department of Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Wenjie Zhang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Zhou
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Taixiang Wu
- Chinese Evidence-Based Medicine Centre/Cochrane Center, West Chinese Hospital, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
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Abstract
Several studies have shown beneficial associations between tea consumption and bone mineral density (BMD) and fracture risk. Current investigations into potential mechanisms of benefit are focused upon the F and polyphenol components of tea. However, previous studies have pointed towards caffeine consumption as a potential risk factor for low BMD and high fracture risk. Tea, therefore, represents an interesting paradox as a mildly caffeinated beverage that may enhance bone health. Fruit and vegetable intake has also been associated with BMD, and it is now apparent that several fruit and vegetable components, including polyphenols, may contribute positively to bone health. Evidence surrounding the function(s) of polyphenol-rich foods in bone health is examined, along with more recent studies challenging the relevance of caffeine consumption to in vivo Ca balance. Plant foods rich in polyphenols such as tea, fruit and vegetables, as significant factors in a healthy diet and lifestyle, may have positive roles in bone health, and the negative role of caffeine may have been overestimated. The present review covers evidence of dietary mediation in positive and negative aspects of bone health, in particular the roles of tea, fruit and vegetables, and of caffeine, flavonoids and polyphenols as components of these foods. Since the deleterious effects of caffeine appear to have been overstated, especially in respect of the positive effects of flavonoids, it is concluded that a reassessment of the role of caffeinated beverages may be necessary.
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Tamaki J, Iki M, Fujita Y, Kouda K, Yura A, Kadowaki E, Sato Y, Moon JS, Tomioka K, Okamoto N, Kurumatani N. Impact of smoking on bone mineral density and bone metabolism in elderly men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study. Osteoporos Int 2011; 22:133-41. [PMID: 20383631 DOI: 10.1007/s00198-010-1238-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 03/01/2010] [Indexed: 12/19/2022]
Abstract
UNLABELLED Our cross-sectional analysis of 1,576 men aged ≥65 years examined smoking effects on bone status. Number of smoking years was associated with decreased bone mineral density (BMD), after adjusting for age, height, weight, and number of cigarettes smoked daily. Smoking did not affect biochemical marker serum values for bone turnover. INTRODUCTION The impact of smoking on bone status in men has not been conclusively established. We examined how smoking and its cessation influence bone status and metabolism in men. METHODS We analyzed 1,576 men among a baseline survey of Japanese men aged ≥65 years, the Fujiwara-kyo Osteoporosis Risk in Men study, conducted during 2007-2008. RESULTS Lumbar spine (LS) BMD values among never, former, and current smokers were 1.045 ± 0.194, 1.030 ± 0.189, and 1.001 ± 0.182 g/cm(2) (P = 0.005), respectively, while total hip (TH) BMD values were 0.888 ± 0.120, 0.885 ± 0.127, and 0.870 ± 0.124 (P = 0.078), respectively. The significant trend for LS BMD remained after adjusting for the covariates; age, height, weight, physical activity, milk consumption, and drinking habit (P = 0.036). Among never and ever (current and former) smokers, LS and TH BMD decreased with the number of pack years or the number of smoking years, respectively, adjusted for those covariates. Among ever smokers, LS and TH BMD decreased with the number of smoking years after adjusting for age, height, weight, and number of cigarettes smoked daily. Smoking did not reveal significant effect for serum osteocalcin or tartrate resistant acid phosphatase isoenzyme 5b. CONCLUSION The impact of smoking on bone status is mainly associated with the number of smoking years in elderly men.
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Affiliation(s)
- J Tamaki
- Department of Public Health, Kinki University School of Medicine, 377-2, Oono-higasi, Osaka-sayama, Osaka, 589-8511, Japan
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Hallström H, Melhus H, Glynn A, Lind L, Syvänen AC, Michaëlsson K. Coffee consumption and CYP1A2 genotype in relation to bone mineral density of the proximal femur in elderly men and women: a cohort study. Nutr Metab (Lond) 2010; 7:12. [PMID: 20175915 PMCID: PMC2842270 DOI: 10.1186/1743-7075-7-12] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 02/22/2010] [Indexed: 11/18/2022] Open
Abstract
Background Drinking coffee has been linked to reduced calcium conservation, but it is less clear whether it leads to sustained bone mineral loss and if individual predisposition for caffeine metabolism might be important in this context. Therefore, the relation between consumption of coffee and bone mineral density (BMD) at the proximal femur in men and women was studied, taking into account, for the first time, genotypes for cytochrome P450 1A2 (CYP1A2) associated with metabolism of caffeine. Methods Dietary intakes of 359 men and 358 women (aged 72 years), participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), were assessed by a 7-day food diary. Two years later, BMD for total proximal femur, femoral neck and trochanteric regions of the proximal femur were measured by Dual-energy X-ray absorptiometry (DXA). Genotypes of CYP1A2 were determined. Adjusted means of BMD for each category of coffee consumption were calculated. Results Men consuming 4 cups of coffee or more per day had 4% lower BMD at the proximal femur (p = 0.04) compared with low or non-consumers of coffee. This difference was not observed in women. In high consumers of coffee, those with rapid metabolism of caffeine (C/C genotype) had lower BMD at the femoral neck (p = 0.01) and at the trochanter (p = 0.03) than slow metabolizers (T/T and C/T genotypes). Calcium intake did not modify the relation between coffee and BMD. Conclusion High consumption of coffee seems to contribute to a reduction in BMD of the proximal femur in elderly men, but not in women. BMD was lower in high consumers of coffee with rapid metabolism of caffeine, suggesting that rapid metabolizers of caffeine may constitute a risk group for bone loss induced by coffee.
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Affiliation(s)
- Helena Hallström
- Research and Development Department, Toxicology Division, National Food Administration, Box 622, SE-751 26 Uppsala, Sweden.
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Duarte PM, Marques MR, Bezerra JP, Bastos MF. The effects of caffeine administration on the early stage of bone healing and bone density. Arch Oral Biol 2009; 54:717-22. [DOI: 10.1016/j.archoralbio.2009.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 04/23/2009] [Accepted: 05/04/2009] [Indexed: 02/04/2023]
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Österberg T, Carlsson GE, Sundh V, Mellström D. Number of teeth – a predictor of mortality in 70-year-old subjects. Community Dent Oral Epidemiol 2008; 36:258-68. [DOI: 10.1111/j.1600-0528.2007.00413.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wetmore CM, Ichikawa L, LaCroix AZ, Ott SM, Scholes D. Association between caffeine intake and bone mass among young women: potential effect modification by depot medroxyprogesterone acetate use. Osteoporos Int 2008; 19:519-27. [PMID: 18004611 DOI: 10.1007/s00198-007-0473-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Accepted: 08/24/2007] [Indexed: 10/22/2022]
Abstract
UNLABELLED This study assessed associations between habitual caffeine intake and bone mass among young women. Analyses of the entire study population revealed no significant associations, while analyses restricted to women using depot medroxyprogesterone acetate (DMPA) showed modest inverse associations between caffeine intake and bone mineral content (BMC). INTRODUCTION Some previous investigations among postmenopausal women suggest an inverse relationship between caffeine intake and bone mass, yet studies of this association among young women are few. METHODS The association between habitual caffeine intake and bone mass was evaluated prospectively in a population-based cohort of 625 females, aged 14 to 40 years, adjusting for relevant biological and lifestyle factors. Caffeinated beverage intake was self-reported, and bone mineral content (BMC) and bone mineral density (BMD) were measured at baseline and every 6 months throughout a 24-month follow-up period using dual-energy x-ray absorptiometry. RESULTS Cross-sectional analyses revealed no significant differences in mean BMC or BMD at baseline. Mean percentage and absolute changes in BMC and BMD were not associated with caffeine use. Repeated measures analyses similarly showed no significant association between caffeine intake at baseline and mean BMC or BMD measured during follow-up. However, among women using depot medroxyprogesterone acetate (DMPA), modest inverse associations between caffeine and BMC (but not BMD) were detected. CONCLUSIONS Our data suggest that heavy habitual consumption of caffeinated beverages does not adversely impact bone mass among young women in general. Greater caffeine intake may be associated with lower BMC among DMPA users.
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Affiliation(s)
- C M Wetmore
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, USA
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Rapuri PB, Gallagher JC, Nawaz Z. Caffeine decreases vitamin D receptor protein expression and 1,25(OH)2D3 stimulated alkaline phosphatase activity in human osteoblast cells. J Steroid Biochem Mol Biol 2007; 103:368-71. [PMID: 17223552 DOI: 10.1016/j.jsbmb.2006.12.037] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Indexed: 11/24/2022]
Abstract
Of the various risk factors contributing to osteoporosis, dietary/lifestyle factors are important. In a clinical study we reported that women with caffeine intakes >300 mg/day had higher bone loss and women with vitamin D receptor (VDR) variant, tt were at a greater risk for this deleterious effect of caffeine. However, the mechanism of how caffeine effects bone metabolism is not clear. 1,25-Dihydroxy vitamin D(3) (1,25(OH)(2)D(3)) plays a critical role in regulating bone metabolism. The receptor for 1,25(OH)(2)D(3), VDR has been demonstrated in osteoblast cells and it belongs to the superfamily of nuclear hormone receptors. To understand the molecular mechanism of the role of caffeine in relation to bone, we tested the effect of caffeine on VDR expression and 1,25(OH)(2)D(3) mediated actions in bone. We therefore examined the effect of different doses of caffeine (0.2, 0.5, 1.0 and 10mM) on 1,25(OH)(2)D(3) induced VDR protein expression in human osteoblast cells. We also tested the effect of different doses of caffeine on 1,25(OH)(2)D(3) induced alkaline phosphatase (ALP) activity, a widely used marker of osteoblastic activity. Caffeine dose dependently decreased the 1,25(OH)(2)D(3) induced VDR expression and at concentrations of 1 and 10mM, VDR expression was decreased by about 50-70%, respectively. In addition, the 1,25(OH)(2)D(3) induced alkaline phosphatase activity was also reduced at similar doses thus affecting the osteoblastic function. The basal ALP activity was not affected with increasing doses of caffeine. Overall, our results suggest that caffeine affects 1,25(OH)(2)D(3) stimulated VDR protein expression and 1,25(OH)(2)D(3) mediated actions in human osteoblast cells.
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Affiliation(s)
- Prema B Rapuri
- Bone Metabolism Unit, Creighton University, School of Medicine, 601 North 30th Street, Omaha, NE 68131, USA.
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Bidula J, Boehm C, Powell K, Barsoum W, Nakamoto C, Mascha E, Muschler GF. Osteogenic progenitors in bone marrow aspirates from smokers and nonsmokers. Clin Orthop Relat Res 2006; 442:252-9. [PMID: 16394769 DOI: 10.1097/01.blo.0000183738.43245.c2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED Bone marrow aspirates contain connective tissue progenitor cells which can proliferate to form cell colonies that express connective tissue phenotypes. The number of osteogenic connective tissue progenitor cells can be estimated by counting colonies that express alkaline phosphatase, an early marker of osteoblastic differentiation. Because tobacco use is associated with decreased bone mass and fracture nonunion, we tested the hypothesis that current or previous tobacco use is an independent determinant of marrow cellularity or prevalence of osteogenic connective tissue progenitor cells among marrow-derived cells. Marrow aspirates were obtained from the anterior iliac crest of 62 patients who were grouped as never smoked, past smokers, or current smokers. The number of nucleated cells per aspirate was determined. Cells were cultured for 6 days in osteogenic media. The prevalence of osteogenic connective tissue progenitor cells was determined by counting colony forming units. The area of each colony was assessed using quantitative image analysis. Cellularity of bone marrow was found to decrease with age. We observed no relationship between smoking status and marrow cellularity, colony prevalence, or colony area. This suggests that tobacco use is not associated with a change in prevalence of osteogenic connective tissue progenitor cells in bone marrow, or their intrinsic biologic capacity to undergo early osteoblastic differentiation. LEVEL OF EVIDENCE Diagnostic Study, Level I (testing of previously developed diagnostic criteria on consecutive patients--with universally applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Jennifer Bidula
- Department of Biomedical Engineering, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Abstract
The nutritional needs for optimizing bone health easily can be met by a diet that is high in fruits and vegetables (five or more servings/day), adequate in protein but moderate in animal protein, and with adequate calcium and vitamin D intakes through the consumption of low fat dairy or calcium-fortified foods. Foods are a preferred source to maintaining calcium balance because there are other essential nutrients that are found in high-calcium foods. For those individuals in whom there is inadequate calcium intake from diet, supplemental calcium can be used. Supplemental or dietary calcium should be spread out throughout the day, with 500 mg or less being consumed at each meal to optimize absorption. In all individuals older than 70 years, vitamin D intakes of at least 600 IU per day (up to 1000 IU/day) are recommended, in addition to the calcium requirement of 1200 mg per day. Vitamin D from foods, supplements, and/or multivitamins can be used to meet the vitamin D requirement. In frail elderly individuals with malabsorption and alcoholics, there may be a need to supplement magnesium. Some elderly individuals with indications of poor nutritional status (low albumin levels) or after hip fracture might benefit from protein supplementation and a multivitamin to ensure adequacy of other nutrients.
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Affiliation(s)
- Jeri W Nieves
- Clinical Research Center, Helen Hayes Hospital, Route 9W, West Haverstraw, NY 10993, USA.
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Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. FOOD ADDITIVES AND CONTAMINANTS 2003; 20:1-30. [PMID: 12519715 DOI: 10.1080/0265203021000007840] [Citation(s) in RCA: 575] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Caffeine is probably the most frequently ingested pharmacologically active substance in the world. It is found in common beverages (coffee, tea, soft drinks), in products containing cocoa or chocolate, and in medications. Because of its wide consumption at different levels by most segments of the population, the public and the scientific community have expressed interest in the potential for caffeine to produce adverse effects on human health. The possibility that caffeine ingestion adversely affects human health was investigated based on reviews of (primarily) published human studies obtained through a comprehensive literature search. Based on the data reviewed, it is concluded that for the healthy adult population, moderate daily caffeine intake at a dose level up to 400 mg day(-1) (equivalent to 6 mg kg(-1) body weight day(-1) in a 65-kg person) is not associated with adverse effects such as general toxicity, cardiovascular effects, effects on bone status and calcium balance (with consumption of adequate calcium), changes in adult behaviour, increased incidence of cancer and effects on male fertility. The data also show that reproductive-aged women and children are 'at risk' subgroups who may require specific advice on moderating their caffeine intake. Based on available evidence, it is suggested that reproductive-aged women should consume </=300 mg caffeine per day (equivalent to 4.6 mg kg(-1) bw day(-1) for a 65-kg person) while children should consume </=2.5 mg kg(-1) bw day(-1).
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Affiliation(s)
- P Nawrot
- Toxicological Evaluation Section, Chemical Health Hazard Assessment Division, Bureau of Chemical Safety, Food Directorate, Health Canada, Tunney's Pasture, PL 2204D1, Ottawa, Ontario, Canada K1A 0L2.
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Ilich JZ, Brownbill RA, Tamborini L, Crncevic-Orlic Z. To drink or not to drink: how are alcohol, caffeine and past smoking related to bone mineral density in elderly women? J Am Coll Nutr 2002; 21:536-44. [PMID: 12480799 DOI: 10.1080/07315724.2002.10719252] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To determine relationship between alcohol, caffeine, past smoking and bone mineral density of different skeletal sites in elderly women, accounting for other biological and life-style variables. METHODS/DESIGN A cross-sectional study in 136 Caucasian women, mean +/- SD age 68.6 +/- 7.1 years, all healthy and free of medications affecting bones, including estrogen. Bone mineral density (BMD) of multiple skeletal regions and body composition were measured by dual X-ray absorptiometry. Serum vitamin D (25-OHD) and parathyroid hormone (PTH) were analyzed and used as confounders. Calcium (Ca) intake was assessed by food frequency questionnaire. Alcohol and caffeine consumption was assessed by questionnaires determining frequency, amount and source of each. There were no current smokers, but the history of smoking was recorded, including number of years and packages smoked/day. Past physical activity was assessed by Allied Dunbar National Fitness Survey and used as confounder. Statistical significance was considered at p <or= 0.05. RESULTS In the correlational analysis, alcohol was positively associated with spine BMD (r = 0.197, p = 0.02), 25-OHD and negatively with PTH. Smoking was negatively related to Ca intake, 25(OH)D and number of reproductive years. In subgroup (stratified by Ca intake) and multiple regression analyses, alcohol (average approximately 0.5-1 drinks/day or approximately 8 g alcohol/day) was favorably associated with BMD of spine and total body. Caffeine (average approximately 2.5 6-fl oz cups/day or 200-300 mg caffeine/day) had negative association with most of the skeletal sites, which was attenuated with higher Ca intake (>or=median, 750 mg/day). The past smokers who smoked on average 24 years of approximately 1 pack cigarettes/day had lower BMD in total body, spine and femur than never-smokers when evaluated in subgroup analyses, and the association was attenuated in participants with >or=median Ca intake. There was no significant association between past smoking and BMD of any skeletal site in multiple regression analyses. CONCLUSION The results support the notion that consumption of small/moderate amount of alcohol is positively, while caffeine and past smoking are negatively associated with most of the skeletal sites, which might be attenuated with Ca intake above 750 mg/day.
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Affiliation(s)
- Jasminka Z Ilich
- University of Connecticut, School of Allied Health, Storrs, CT 06269, USA.
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Abstract
Caffeine-containing beverage consumption has been reported to be associated with reduced bone mass and increased fracture risk in some, but not most, observational studies. Human physiological studies and controlled balance studies show a clear but only a very small depressant effect of caffeine itself on intestinal calcium absorption, and no effect on total 24-h urinary calcium excretion. The epidemiologic studies showing a negative effect may be explained in part by an inverse relationship between consumption of milk and caffeine-containing beverages. Low calcium intake is clearly linked to skeletal fragility, and it is likely that a high caffeine intake is often a marker for a low calcium intake. The negative effect of caffeine on calcium absorption is small enough to be fully offset by as little as 1-2 tablespoons of milk. All of the observations implicating caffeine-containing beverages as a risk factor for osteoporosis have been made in populations consuming substantially less than optimal calcium intakes. There is no evidence that caffeine has any harmful effect on bone status or on the calcium economy in individuals who ingest the currently recommended daily allowances of calcium.
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Affiliation(s)
- R P Heaney
- Creighton University, 2500 California Plaza, Omaha, Nebraska 68178, USA.
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Abstract
Osteoporosis is a serious health problem for men. An advance in our understanding of the pathophysiology and treatment of this disorder has resulted in the possibility of a gender-specific approach to screening, diagnosis, and treatment. Here we review the data on osteoporosis in men, discuss controversies regarding whom to screen, whom to treat, and how to treat. Recent treatment data as they relate to men are reviewed, and a clinical treatment algorithm is presented.
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Affiliation(s)
- Elizabeth Burgess
- Emory University School of Medicine and VA Medical Center, Atlanta, Georgia, USA
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Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001; 74:694-700. [PMID: 11684540 DOI: 10.1093/ajcn/74.5.694] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The role of caffeine as a risk factor for bone loss is controversial. OBJECTIVE Our goals were 1) to compare in both a cross-sectional study and a 3-y longitudinal study the bone mineral density (BMD) of postmenopausal women consuming high or low amounts of caffeine and 2) to study the interaction between caffeine intake, vitamin D receptor (VDR) polymorphism, and BMD in the longitudinal study. DESIGN The results are derived from cross-sectional measurements of BMD in 489 elderly women (aged 65-77 y) and from longitudinal measurements made in 96 of these women who were treated with a placebo for 3 y. Changes in BMD were adjusted for confounding factors and were compared between groups with either low (< or =300 mg/d) or high (>300 mg/d) caffeine intakes and between the VDR genotype subgroups of the low- and high-caffeine groups. RESULTS Women with high caffeine intakes had significantly higher rates of bone loss at the spine than did those with low intakes (-1.90 +/- 0.97% compared with 1.19 +/- 1.08%; P = 0.038). When the data were analyzed according to VDR genotype and caffeine intake, women with the tt genotype had significantly (P = 0.054) higher rates of bone loss at the spine (-8.14 +/- 2.62%) than did women with the TT genotype (-0.34 +/- 1.42%) when their caffeine intake was >300 mg/d. CONCLUSIONS Intakes of caffeine in amounts >300 mg/d ( approximately 514 g, or 18 oz, brewed coffee) accelerate bone loss at the spine in elderly postmenopausal women. Furthermore, women with the tt genetic variant of VDR appear to be at a greater risk for this deleterious effect of caffeine on bone.
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Affiliation(s)
- P B Rapuri
- Bone Metabolism Unit, Creighton University, School of Medicine, Omaha, NE 68131, USA.
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22
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Abstract
To determine the magnitude and mediators of the association between cigarette smoking and bone mass in the epidemiologic literature we reviewed articles, published abstracts, and conference proceedings, identified through MEDLINE, psychological abstracts, conference proceedings, and article bibliographies. We studied cross-sectional and prospective human studies that provided a quantitative measure of bone mass (X-ray, absorptiometry, or computed tomography) as a function of cigarette smoking exposure. Effects were expressed as pooled standardized mean differences for categorical comparisons (e.g., bone mass in current versus nonsmokers), and as pooled correlation coefficients for continuous comparisons (e.g., correlation of bone mass and pack-years of smoking). Effects were derived for combined bone sites (all bone sites pooled within each study) and four specific sites (hip, lumbar spine, forearm, and os calcis), and were examined overall and as a function of subject and methodologic characteristics (gender, age, body weight, menopausal status, health status). Data were pooled across 86 studies, enrolling 40,753 subjects. Smokers had significantly reduced bone mass compared with nonsmokers (never and former smokers) at all bone sites, averaging a one-tenth standard deviation (SD) deficit for combined sites. Deficits were especially pronounced at the hip, where the bone mass of current smokers was one-third of a SD less than that of never smokers. Overall, effects were greatest in men and in the elderly, and were dose-dependent. In prospective studies, smokers had greater rates of bone loss over time compared with nonsmokers. Bone mass differences remained significant after controlling for age and body weight differences between the two groups. Absolute effect sizes at most bone sites were greatest for current smokers compared with never smokers, intermediate for current smokers compared with former smokers, and lowest for former smokers compared with never smokers, suggesting that smoking cessation may have a positive influence on bone mass. Based on these data, it is estimated that smoking increases the lifetime risk of developing a vertebral fracture by 13% in women and 32% in men. At the hip, smoking is estimated to increase lifetime fracture risk by 31% in women and 40% in men. It appears that smoking has an independent, dose-dependent effect on bone loss, which increases fracture risk, and may be partially reversed by smoking cessation. Given the public health implications of smoking on bone health, it is important that this information be incorporated into smoking prevention and cessation efforts.
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Affiliation(s)
- K D Ward
- The University of Memphis Center for Community Health, Tennessee, USA
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Freeman D, Randall DB. Stress fracture of the foot secondary to osteoporosis: an atypical presentation. J Am Podiatr Med Assoc 2001; 91:99-101. [PMID: 11266487 DOI: 10.7547/87507315-91-2-99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
BACKGROUND By increasing the urinary excretion of calcium, caffeine consumption may reduce bone mineral density (BMD) and subsequently increase the risk for osteoporotic fracture. Although negative associations between caffeine consumption and BMD have been reported for postmenopausal women, in particular for those who consume low amounts of dietary calcium, the relation between caffeine and BMD in younger women is unclear. Therefore, we evaluated the association between caffeine consumption and BMD in a cross-sectional study of 177 healthy white women, age 19-26 years, who attended a Midwestern university. METHODS Average caffeine intake (milligrams per day) was calculated from self-reports of the consumption of coffee, decaffeinated coffee, tea, colas, chocolate products, and select medications during the previous 12 months (mean caffeine intake = 99. 9 mg/day). BMD (grams per square centimeter) at the femoral neck and the lumbar spine was measured by dual-energy X-ray absorptiometry. RESULTS After adjusting in linear regression models for potential confounders, including height, body mass index, age at menarche, calcium intake, protein consumption, alcohol consumption, and tobacco use, caffeine consumption was not a significant predictor of BMD. For every 100 mg of caffeine consumed, femoral neck BMD decreased 0.0069 g/cm(2) (95% confidence in terval [CI] = -0.0215, 0. 0076) and lumbar spine BMD decreased 0.0119 g/cm(2) (95% CI = -0. 0271, 0.0033). No single source of caffeine was significantly associated with a decrease in BMD. Furthermore, the association between caffeine consumption and BMD at either site did not differ significantly between those who consumed low levels of calcium (< or =836 mg/day) and those who consumed high levels of calcium (>836 mg/day). CONCLUSIONS Caffeine intake in the range consumed by young adult women is not an important risk factor for low BMD.
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Affiliation(s)
- A J Conlisk
- Biological and Biomedical Sciences Division, Nutrition and Health Sciences Program, Emory University, Atlanta, Georgia 30322, USA.
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Hansen SA, Folsom AR, Kushi LH, Sellers TA. Association of fractures with caffeine and alcohol in postmenopausal women: the Iowa Women's Health Study. Public Health Nutr 2000; 3:253-61. [PMID: 10979145 DOI: 10.1017/s136898000000029x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess whether alcoholic and caffeinated beverages are associated with risk of fractures in women. SETTING Population-based sample surveyed by post. SUBJECTS A total of 34 703 postmenopausal Iowan women aged 55-69 years were surveyed. DESIGN A cohort of women reported alcoholic and caffeinated beverage intake and were followed for 6.5 years for fracture occurrence. Relative risks (RR) and 95% confidence intervals (CI) were computed using Cox proportional hazards regression. Covariates included age, tobacco use, physical activity, body mass index (BMI), waist to hip ratio (WHR), oestrogen use and calcium intake. RESULTS At least one fracture was reported by 4378 women (389 upper arm, 288 forearm, 1128 wrist, 275 hip, 416 vertebral and 2920 other fractures). The adjusted RR for highest versus lowest caffeine intake quintiles was 1.09 (95% CI 0.99-1.21) for combined fracture sites. Wrist fractures were associated positively (RR for extreme quintiles 1.37, 95% CI 1.11-1.69) and upper arm fractures were negatively associated (RR 0.67, 95% CI 0.48-0.94) with caffeine intake. The age-adjusted RR of total fractures for highest versus lowest frequency of beer usage was 1.55 (95% CI 1.25-1.92) and for liquor was 1.25 (95% CI 1.03-1.54). No other association was found between any specific fracture site and alcohol intake. CONCLUSIONS We found a modest increase in fracture risk associated with highest caffeine intake, varying by site. Alcohol intake was low, but it also showed a weak positive association with fracture risk.
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Affiliation(s)
- S A Hansen
- Division of Epidemiology, School of Public Health, Suite 300, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454-1015, USA
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Lloyd T, Rollings NJ, Kieselhorst K, Eggli DF, Mauger E. Dietary caffeine intake is not correlated with adolescent bone gain. J Am Coll Nutr 1998; 17:454-7. [PMID: 9791842 DOI: 10.1080/07315724.1998.10718793] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study was conducted to determine whether dietary caffeine consumed by American white females between ages 12 to 18 affects total body bone mineral gain during ages 12 to 18 or affects hip bone density measured at age 18. METHODS The Penn State Young Women's Health Study is a longitudinal investigation of bone, endocrine and cardiovascular health in non-Hispanic, white, teenage women. Nutrient and food group intakes were obtained by averaging over 6 years of prospective diet records. The cohort, as of age 18, (n = 81) was separated into three subgroups according to mean daily caffeine intake averaged across ages 12 to 18. Group I (n = 37) consumed less than 25 mg caffeine per day; Group II (n = 33) consumed 25 to 50 mg caffeine per day; and Group III (n = 11) consumed greater than 50 mg caffeine per day. The group mean daily caffeine intakes (SD) were Group I = 14 (6) mg/day; Group II = 35 (7) mg/day; Group III = 77 (27) mg/day. Total body bone gain and hip bone density were determined by dual energy x-ray absorptiometry (DXA). RESULTS There were no significant differences among the three caffeine intake groups for total body bone mineral gain during the ages 12 to 18 or of hip bone density at age 18. The low caffeine intake group consumed more milk (and therefore more calcium) and more fruit per day than did the other two groups. Group III, the highest caffeine intake group, consumed more sugar per day than did the other two groups. The observed differences in nutrient and food intakes among the three groups were not associated with any differences in anthropometric measurements or bone gain among the three groups. CONCLUSION These findings indicate that dietary caffeine intake at levels presently consumed by American white, teenage women is not correlated with adolescent total bone mineral gain or hip bone density at age 18.
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Affiliation(s)
- T Lloyd
- Department of Obstetrics and Gynecology, Penn State College of Medicine, USA
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Whitmore SE, Levine MA. Risk factors for reduced skin thickness and bone density: possible clues regarding pathophysiology, prevention, and treatment. J Am Acad Dermatol 1998; 38:248-55. [PMID: 9486682 DOI: 10.1016/s0190-9622(98)70600-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The decline in skin thickness that occurs with aging interests many different groups. Among these are pharmaceutical, cosmeceutical, and cosmetic companies promoting antiaging or antiwrinkling products, geriatricians and rheumatologists treating elderly and steroid-dependent patients who are "outliving" their skin, cosmetic surgeons, and dermatologists. Dermatologists are frequently asked how to prevent or slow aging of the skin. The answer regarding "photoaging" of sun-exposed skin is obvious; the answer regarding aging of photoprotected skin is not. Although the bulk of epidemiologic literature about aging and thinning of photoprotected skin is from the 1970s, literature regarding risk factors for and treatment of aging and thinning of the bony skeleton is more recent. Because both skin and bone are composed of more than 70% type I collagen, it may be hypothesized that the pathophysiologic processes involved in chronological atrophy of both tissues may overlap, thereby providing a foundation for further investigation of the skin. A better understanding of skin and bone loss may motivate the "appearance-conscious" public to modify risk factors (e.g., begin exercising) or select hormonal therapies (e.g., postmenopausal hormone replacement) to reduce aging of the skin. These measures may provide additional benefits, such as decreasing the risk of osteoporosis.
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Affiliation(s)
- S E Whitmore
- Department of Dermatology, The Johns Hopkins University, Baltimore, Maryland, USA
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Suzuki T, Yoshida H, Hashimoto T, Yoshimura N, Fujiwara S, Fukunaga M, Nakamura T, Yoh K, Inoue T, Hosoi T, Orimo H. Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean Osteoporosis Study (MEDOS) questionnaire. Bone 1997; 21:461-7. [PMID: 9356741 DOI: 10.1016/s8756-3282(97)00179-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case-control study of hip fracture among the Japanese elderly was carried out in order to assess the risk factors for fractures. On the data obtained from 249 cases and 498 controls matched with ethnicity, sex, age, and residential area, significant risk factors on the lifestyle by multivariate analyses included drinking more than three cups of coffee daily, living in rural areas in the past, sleep disturbance, stroke with hemiplegia, and sleeping in a (Western-type) bed. In contrast, in addition to possession of a large body mass index, moderate alcohol intake and eating fish appeared to be associated with a reduced risk of hip fracture. In conclusion, some traditional Japanese lifestyle characteristics may prevent hip fractures among the Japanese elderly.
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Affiliation(s)
- T Suzuki
- Department of Epidemiology, Tokyo Metropolitan Institute of Gerontology, Japan
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Vogel JM, Davis JW, Nomura A, Wasnich RD, Ross PD. The effects of smoking on bone mass and the rates of bone loss among elderly Japanese-American men. J Bone Miner Res 1997; 12:1495-501. [PMID: 9286767 DOI: 10.1359/jbmr.1997.12.9.1495] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bone density and bone loss rates were examined among Japanese-American men categorized as current cigarette smokers, past smokers, and nonsmokers. The design included a retrospective study of smoking and bone density and a prospective study of current smoking and bone loss rates. The mean length of follow-up was 5 years; the setting was the island of Oahu. The subjects included 1303 men in the Hawaii Osteoporosis Study, 51-82 years old at their initial examination. Twenty percent were current smokers, 45% past smokers, and 35% had never smoked. Their bone density was measured at the distal and proximal radius and calcaneus using single photon absorptiometry. Compared with never smokers, current and past smokers had significantly lower bone density, especially in the predominantly cancellous calcaneus (4.8 and 4.3% lower, respectively) and partially trabecular distal radius (1.8 and 3.3% lower, respectively). The magnitude of the smoking effect was linked strongly to the duration of smoking and also to the number of cigarettes smoked. Bone loss rates subsequent to the initial measurement were greater in the current smokers than the never smokers (20.5, 27.2, and 9.7% greater at the calcaneus, distal, and proximal radius, respectively) but the differences did not achieve significance. Smokers of more than one pack per day had 32.0, 77.6, and 30.7% greater loss rates than never smokers in these same sites; the difference achieved significance at the distal radius. The results from the distal radius suggest that these smokers may increase their fracture risk 10-30% per decade of smoking. The adverse effects of smoking appeared to be greater in cancellous than cortical bone.
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Affiliation(s)
- J M Vogel
- University of California Davis, School of Medicine, Division of Nuclear Medicine, Sacramento, USA
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Case TS, Saltzman MJ, Cheuk J, Yazdani M, Sadeghpour A, Albrecht D, Rossowska MJ, Nakamoto T. Combined effects of caffeine and alcohol during pregnancy on bones in newborn rats. RESEARCH IN EXPERIMENTAL MEDICINE. ZEITSCHRIFT FUR DIE GESAMTE EXPERIMENTELLE MEDIZIN EINSCHLIESSLICH EXPERIMENTELLER CHIRURGIE 1996; 196:179-185. [PMID: 8875704 DOI: 10.1007/bf02576840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The combined effects of caffeine and alcohol on mineral contents of fetal mandibles and femurs were studied. Pregnant rats were divided into four groups: group 1, control; group 2, caffeine; group 3, alcohol; and group 4, caffeine-plus-alcohol. Alcohol (1.0 g ethanol/kg body weight) was intubated twice daily, beginning at day 9 of gestation. Caffeine (2 mg/100 g body weight) was given as a dietary supplement. Groups 1 and 2 were intubated with isocaloric sucrose solution. At birth, randomly selected pups were killed and the mandible and femur were removed and dried. Ca, P, Mg, Zn and hydroxyproline in these bones were measured. Notwithstanding the dams' intake of caffeine and alcohol administered separately, the present results suggest that the combination of caffeine and alcohol exhibited the most detrimental effects.
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Affiliation(s)
- T S Case
- Department of Physiology, Louisiana State University Medical Center, New Orleans 70119, USA
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Kiel DP, Zhang Y, Hannan MT, Anderson JJ, Baron JA, Felson DT. The effect of smoking at different life stages on bone mineral density in elderly men and women. Osteoporos Int 1996; 6:240-8. [PMID: 8783299 DOI: 10.1007/bf01622741] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To assess the effect of smoking on bone mineral density (BMD) at different life stages, to examine whether the effect of smoking differs between men and women, and to discover whether its effect in women differs according to history of estrogen use, a cohort study was carried out with single cross-section measurement of BMD by single and dual photon absorptiometry. The setting was the Framingham Study, a population-based cohort study with over 40 years prospectively collected data on smoking. Subjects (n = 1164) consisted of cohort members participating in the 20th biennial Framingham examination (1988-1989). The measurements included in the study were BMD measured at the hip, spine and radius, smoking history ascertained at all Framingham Study examinations since 1948, and other factors affecting BMD (age, weight, estrogen use, caffeine use, alcohol use and physical activity). Neither current smoking, recent (last 10 years) smoking, nor early adulthood smoking resulted in significantly lower BMD at any skeletal site among women who had not taken estrogen. Among women who had taken estrogen, BMD at most sites was lower among current or recent smokers, although the small numbers of smokers made it difficult to find significant differences at all skeletal sites. Among men, a consistently lower BMD at all skeletal sites was observed for smokers regardless of when in their life they smoked (4-15.3% lower), although the effect of smoking during early adulthood was of a lesser magnitude (4-8% lower). Former male smokers who had quit < 10 years ago had lower BMD than men who had quit > or = 10 years ago. In conclusion, in women who had used estrogen, BMD was lower in current or recent smokers than it was in non-smokers. In men, smoking at any stage of life had adverse effects on the skeleton that was independent of weight, alcohol or caffeine use, implying other mechanisms for smoking's effect on bone.
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Affiliation(s)
- D P Kiel
- Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, MA 02131, USA
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Watson EL, Katz RV, Adelezzi R, Gift HC, Dunn SM. The measurement of mandibular cortical bone height in osteoporotic vs. non-osteoporotic postmenopausal women. SPECIAL CARE IN DENTISTRY 1995; 15:124-8. [PMID: 8619174 DOI: 10.1111/j.1754-4505.1995.tb00494.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The asymptomatic progression of osteoporosis, in conjunction with the possibility of catastrophic disability, makes this disorder a major public health priority. Various body sites, including the mandible, have shown susceptibility to decreasing bone density. In 1986, Benson et al. proposed a radiomorphometric technique called the Panoramic Mandibular Index (PMI) as an inexpensive noninvasive dental technique for osteoporosis screening, although no osteoporotic subjects were included in their study. The purpose of our study was to determine whether osteoporotic postmenopausal women would show a decrease in mandibular cortical bone height, as measured by the PMI index, when compared with nonosteoporotic postmenopausal women. Seventy-two Caucasian females (33 cases/39 controls), aged 54-71 years old, were selected through records and screening via a dual-energy x-ray absorptiometry scan (LUNAR-DEXA). ANOVA analysis indicated no differences in the mean PMI between case and control groups (0.37 +/- 0.15 and 0.38 +/- 0.13, respectively; p = 0.69). Other techniques, such as computer digitized radiography should be explored to test the validity of the PMI.
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Affiliation(s)
- E L Watson
- National Institute of Dental Research, Disease Prevention Health Promotions Branch, Bethesda, MD, USA
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Landin-Wilhelmsen K, Wilhelmsen L, Lappas G, Rosén T, Lindstedt G, Lundberg PA, Wilske J, Bengtsson BA. Serum intact parathyroid hormone in a random population sample of men and women: relationship to anthropometry, life-style factors, blood pressure, and vitamin D. Calcif Tissue Int 1995; 56:104-8. [PMID: 7736316 DOI: 10.1007/bf00296339] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Intact parathyroid hormone (PTH) in serum was determined in a random population sample and was related to age, sex, body composition, life-style factors, blood pressure, blood lipids, plasma fibrinogen, and serum IGF-1, osteocalcin, and vitamin D. Within the framework of the WHO MONICA Project in the city of Göteborg, Sweden, 181 men and 166 women aged 25-64 years were studied. Intact PTH concentrations varied with age but were similar in both sexes (range 4-82 ng/liter) [mean (+/- SD) 23.8 +/- 10.4 ng/liter in men and 25.1 +/- 10.6 ng/liter in women]. Intact PTH concentrations increased with increasing age, body mass index, systolic blood pressure, and 1,25(OH)2D3 and decreased with increasing 25(OH)D3 in all subjects. Additionally, in men, intact PTH correlated positively to diastolic blood pressure and negatively to coffee consumption. In women, PTH also correlated negatively to smoking and IGF-1. In a multivariate analysis including all variables, age lost its significance. In both sexes there were independent positive relations between intact PTH and body mass index and 1,25(OH)2D3, and negative relations between PTH and smoking habits as well as 25(OH)D3; among men there was also negative relations between PTH and coffee consumption. The results indicate that life-style factors such as smoking and coffee consumption decrease the serum concentration of intact PTH, and the same effect is seen in individuals with low body mass index. Coffee intake, smoking, and low body mass index are also known to adversely affect bone mineral content, highlighting the relationship between PTH and bone metabolism.
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Johansson C, Mellström D, Milsom I. Reproductive factors as predictors of bone density and fractures in women at the age of 70. Maturitas 1993; 17:39-50. [PMID: 8412842 DOI: 10.1016/0378-5122(93)90122-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The importance of reproductive and other health and social factors as predictors of bone mineral density (BMD) and fractures was investigated in a longitudinal study of 70-year-old women. At 70 years of age there was no correlation between menarcheal age, menopausal age, duration of fertile period and parity and BMD or a history of fractures. Bilateral oophorectomy (mean age at surgery 45.3 +/- 3.6 years) and the duration of tobacco smoking were negatively correlated to BMD at 70 years of age. Tobacco smoking was positively correlated to a history of fractures and body mass index (BMI) was negatively correlated to a history of fractures at 70 years of age. In a stepwise multiple regression model, height, body mass index and a history of hysterectomy were found to have a contributory, positively-correlated independent explanatory value for BMD at 70 years. In a logistic multiple regression analysis, bilateral oophorectomy was the only independent explanatory factor for fractures at 70 years of age. BMD was lower in women who had undergone bilateral oophorectomy compared with controls at 70 years of age. Hysterectomized women without bilateral oophorectomy showed a higher BMD in the right calcaneus at 70 years of age compared with controls. When comparing the reduction in bone mineral density between 70 and 76 years of age, the fifth quintile (women with the highest BMD) at 70 years of age decreased 2.7 times more (P < 0.01) than the first quintile. A longitudinal examination between 70 and 76 years revealed that BMD at the age of 70 was a significant (P < 0.01) predictor for fractures occurring between 70 and 76 years of age.
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Affiliation(s)
- C Johansson
- Department of Geriatric Medicine, Vasa Hospital, Gothenburg, Sweden
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Lerner UH, Mellström D. Caffeine has the capacity to stimulate calcium release in organ culture of neonatal mouse calvaria. Calcif Tissue Int 1992; 51:424-8. [PMID: 1451009 DOI: 10.1007/bf00296675] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In view of the possible association between ingestion of caffeine (a constituent of coffee, tea, and several beverages) and osteoporosis, we have studied the effect of caffeine on bone resorption in vitro. Caffeine caused a dose-dependent increase of the spontaneous release of 45Ca from neonatal mouse calvarial bones. The effect of caffeine was less pronounced than that of parathyroid hormone (PTH), but of the same magnitude as that of theophylline, a structurally related methylxanthine. The enhancement of 45Ca release induced by caffeine and PTH was observed in 5 days culture. In 2 days culture, however, only PTH stimulated mineral mobilization. The delayed stimulatory effect of caffeine in long-term cultures was abolished by indomethacin and flurbiprofen. In indomethacin-treated bones, however, caffeine potentiated the stimulatory effect on 45Ca release induced by choleratoxin and forskolin. In contrast, caffeine did not potentiate 45Ca release stimulated by PTH. These data show that caffeine can stimulate calcium release from bone in vitro and that this effect is due to potentiation of a stimulatory action of a bone resorptive agonist acting via the adenylate cyclase-cyclic AMP system.
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Affiliation(s)
- U H Lerner
- Department of Oral Cell Biology, University of Umeå, Sweden
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Mannius S, Mellström D, Lindstedt G, Zetterberg C. Health status and risk for hip fracture: a case control study of 70–75-year-olds. Arch Gerontol Geriatr 1992; 15:151-62. [PMID: 15374372 DOI: 10.1016/0167-4943(92)90015-v] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/1991] [Revised: 07/24/1992] [Accepted: 07/29/1992] [Indexed: 11/19/2022]
Abstract
A study concerning health status and social factors was performed of all hip fracture patients (n = 868) admitted to the orthopaedic clinics in Gothenburg, Sweden, during the course of 1 year. All non-institutionalized patients aged 70-75 years were invited 6 months after the fracture to a case-control survey with age-matched controls from the gerontological studies in Gothenburg. The hip-fracture patients had lower body mass index (BMI), lower bone mineral content (BMC) and higher prevalence of vertebral compression fractures. The serum concentrations of osteocalcin, aminoterminal peptide from procollagen-III and alkaline phosphatase activity were higher in the fracture group while serum creatinine concentrations and muscle strength were significantly lower. The prevalences of previous stroke and of Parkinsonism were greater in the hip fracture group. No differences in medication were observed. Thirty-nine percent of the hip fracture patients were suffering from pain and 88% had some form of walking disability at the follow-up study.
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Affiliation(s)
- S Mannius
- Department of Geriatric Medicine, University of Gothenburg, Sweden
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HOLM KARYN, WILBUR JOELLEN, DAN ALICE, MONTGOMERY ANDREW, CHANDLER PEGGY, WALKER JANE. Bone Loss in Mid-Life Women. J Womens Health (Larchmt) 1992. [DOI: 10.1089/jwh.1992.1.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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